HomeMy WebLinkAboutBuilding Permit 09-0232
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LI4G
DEE-t<.rl'&LtJ c..jlZ Sf-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
White
Pink
Yellow
I PERMIT NO. oct - 252--1
File
City
Applicant
ZONING (office use)
OWNER
(Name) If 6 Bf: J<r
S'A fY1 {;
t>
I{ if 1-1 L f r<..
(Phone) 95...2 - y LJ 7-...2 t, cf -2-
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address) )
..~
('J L f) f<
M rtJ
kJEST 't;~,
(Phone) 7 to3 - s--s7 - ~ 7 0 :1-
(Phone)
'tfL/V IJ u S1-
t<.1<. II L v IJ --
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 FIreplace
OAddition OAlteration OUtility Connection
CODE: r:!jt.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV V
I M
3 4
I
E
II
F
I
o Mise
A
R
5
B
S
U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have hlrmshed mformatlOn on this application which IS to the best of my knowledge true and correct. I also certIfy that I am the owner or authOrIzed agent for the
above-mentIoned property and that all construction will conform to all existIng state and local laws and will proceed in accordance with submItted plans I am aware that the buildIng
offiCIal ean revoke thIS pelmlt for Just cause FUlthelmore, I heleby agree that the City offiCIal or a deSignee may enter upon the propelty to pel form needed mspectlons
X 1<,0, )(~ 5---~-~1
Signature Contractor's Ltcense No Date
Permit Valuation
Permit Fee
z...~. -
$ 1A.1t6
$
$ .z.6>
$
$
$
$
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Park Support Fee # $ I
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ lb. .
I ~~ceitz;J IE? rtJ7- I
Paid
Date
-r ~-- - ,
':;;j '7../0{
ThiS IS to certify that the request m the abuve applicatIOn and accompanymg documents is 10 accordance With the City Zuning Ordinance and may proceed as requested ThiS ducument
when signed by the CIty Planner CllnstJtutes a lemporalY Certificate of Zonmg cumpllance and alluws construction to commence. Before occupancy, a Certltlcale ufOccupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS S MCo ~~F\6"'-\")
TIPEOFWORK ~o~ ~
USE OF BUILDING _ _ I I
PERMIT NO. 0". DATE ISSUED '5>/& 10,\
BUILDER ~1"'" iLA~\-~ PHONE # 44' ..z..(c. B2..
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
1---- I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING~NSUL-A.T"'O~ I I
I FINAL. I I
FOR ALL INSPECTIONS (952) 447-9850